1. Field of the Invention
The present invention relates to a method and computer readable medium for merging studies. More particularly, the present invention relates to a method and computer readable medium for merging medical studies into a composite medical study in a medical information management system.
2. Description of the Related Art
Typically, a physician will order or prescribe for a patient certain examinations, such as an X-ray or ultrasound examination. When such an examination is being performed, a user will typically generate a “medical” study which will contain the examination results. The study may be stored according to a DICOM (Digital Imaging and Communication in Medicine) standard, a format for Agilent Technology's medical information management system called EnConcert, known as DSR-TIFF, or as another storage format. DICOM is a prevailing standard for medical imaging management, with EnConcert conforming thereto. According to DICOM lexicon, when an examination is to be performed, a “Requested Procedure” is generated, where collected information will be collated. Likewise, according to DICOM, the term “study” corresponds to a collection of information associated with the Requested Procedure, i.e., the collection of information associated with the examination being performed. Likewise, the term “study” in EnConcert, similarly relates to DICOM's information collection that is associated with the Requested Procedure. In embodiments of applicants' invention, the term “study” corresponds to the “collected,” rather than “collecting of,” information for an examination, and most closely relates to an overall combination of “Performed Procedure Steps,” according to the DICOM standard, with each DICOM Performed Procedure Step including the collected information. In the embodiments of applicants' invention, the term “procedure” will be used to correspond to a similar combination of collected information, as in the DICOM Performed Procedure Step, with a study having potentially multiple procedures. Lastly, in the embodiments of applicant's invention, the term “protocol” corresponds to an identification of a type of examination, e.g., a stress test, including either standard or individualized instructions as to what data is to be, or was, collected for such an examination, or even how the collected data is to be collated or calculated.
A problem surfaces when the user performs a multiple number of save attempts or transmissions, during an examination, either intentionally or by accident. Some examples of this scenario include: 1) an inadvertent termination of the examination while in progress, due to user error; 2) deliberate premature termination of the examination, either to accommodate the patient's or another patient's needs; 3) a request for additional artifacts, including, but not limited to, images and/or measurements based on a preliminary review of a study including the information obtained in the examination; or 4) failing of transmissions, thereby fragmenting information related to a single examination into more than one study upon an attempted re-transmission, though this fragmenting of information is less prevalent in more robust systems. The multiple save attempts or transmissions can cause separate studies to be created, where the separate studies should logically be considered as corresponding to one examination or related examinations. Each study generated may have its own unique identifiers (UIDs), which may cause errors or difficulty in generating a single diagnostic report based on the different studies.
Conventionally, to prevent these above problems, some systems have been designed to collate all the information for an examination before sending the information to a medical information management system, where the collated information is included in one study. According to this technique, when a physician requests an examination to be performed, a Study Instance UID is allocated to the Requested Procedure. Typically, using a DICOM Modality Worklist service or other schemes, a list of Requested Procedures may be accessed on acquisition equipment, with one Requested Procedure being selected for a particular patient examination. This permits the acquisition equipment to mark every deliverable artifact of the examination, e.g., images, measurements, and reports, etc, with the Study Instance UID before sending the artifacts, to the medical information management system, viewer, or archive. Thus, the receiving equipment may unambiguously identify all artifacts related to the original study. Subsequent examinations may be performed and information acquired from the same Requested Procedure, which would also have all deliverable artifacts marked with the same Study Instance UID. As long as both acquisition equipment and receiving equipment are implemented in an intended manner, the need of merging two associated studies would be reduced, as the generation of multiple studies, corresponding to multiple Requested Procedures with different Study Instance UIDs, is typically prevented.
However, if the subsequent examinations are not performed using the acquisition equipment with the proper Requested Procedure, having the proper Study Instance UID, a different study may be generated in the receiving equipment and the new collected artifacts would not be combined with the proper study. Also, additional studies may be generated if the examination is performed in an emergency room situation, without a study order or manual entry of patient identification to acquire the Requested Procedure, or perhaps while a network is down. Further, additional studies may be generated when a related examination is performed by different health providers with differing systems, and thus be based on a different Requested Procedure or perhaps not even based on a Requested Procedure. These examples are only illustrative of the problems associated with the conventional systems and should not be considered as being limiting of the potential problems not listed herein.
Therefore, to overcome these problems associated with the generation of two or more logically related separate studies, the present invention sets forth a merging capability for the separate unique studies.